神经导航下应用神经内镜经组织导管扩张器清除颅内血肿疗效研究

Study on the efficacy of neuroendoscopy through tissue catheter dilator to clear intracranial hematoma under neuronavigation

目的:探讨神经导航下应用神经内镜经组织导管扩张器清除颅内血肿的疗效。方法:选取2017年3月~2020年8月临床上收治的60例颅内血肿患者分为观察组和对照组,对照组给予开颅血肿清除术治疗,观察组给予神经导航下应用神经内镜经组织导管扩张器清除术治疗,比较两组患者临床指标、血肿清除情况、术后3个月预后情况、术前及术后3个月NIHSS评分、术后6个月ADL分级、并发症发生情况。结果:观察组患者手术时间、术中出血量较对照组显著降低(P<0.05);两组患者颅内血肿清除情况无显著性差异(P>0.05);术后3个月观察组患者预后情况优于对照组(P<0.05);术前两组患者NIHSS评分无显著性差异(P>0.05),术后3个月观察组患者NIHSS评分较对照组下降更显著(P<0.05);术后6个月观察组患者ADL分级优于对照组(P<0.05);两组患者术后并发症发生率无显著性差异(P>0.05)。结论:神经导航下应用神经内镜经组织导管扩张器清除颅内血肿可以达到与开颅手术相当的血肿清除效果,并且可缩短手术时间,减少出血量,减轻对患者的创伤,促进患者神经功能恢复,改善日常生活功能,提高生存质量。

Objective:To investigate and analyze the efficacy of neuroendoscopy to remove intracranial hematoma through tissue catheter dilator under neuronavigation.Method:60 patients with intracranial hematoma who were clinically admitted from March 2017 to August 2020 were selected and divided into observation group and control group.The control group was treated with craniotomy hematoma removal,and the observation group adopted neuroendoscope through tissue catheter dilator under neuronavigation to remove intracranial hematoma.The clinical indicators,hematoma removal,prognosis of 3 months after the operation,NIHSS scores before and 3 months after surgery,ADL classifications at 6 months after surgery,and complications were compared between the two groups.Results:The operation time and intraoperative blood loss of the observation group were significantly lower than those of the control group(P<0.05).There was no significant difference in intracranial hematoma between the two groups(P>0.05).The prognosis of the observation group was better than that of the control group at 3 months after surgery(P<0.05).There was no significant difference in NIHSS scores between the two groups before surgery(P>0.05).the NIHSS score of the two groups decreased significantly after 3 months(P<0.05),and the NIHSS score of the observation group decreased more significantly(P<0.05).The ADL classification of the observation group was better than that of the control group at 6 months after the operation(P<0.05),and there was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:The application of neuroendoscope through tissue catheter dilator under neuronavigation to remove intracranial hematoma can reach the equivalent of craniotomy Hematoma removal effect,and can shorten the operation time,reduce the amount of bleeding,reduce the trauma to the patient,promote the recovery of the patient's nerve function,improve the function of daily life,and improve the quality of life.